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Followup To
Question -
There are presently large numbers of students in our high school with pink eye.(bacterial) There has been some disagreement among the teachers as to the length of time that a student must remain at home after starting treatment for this. Some say 24 hours- others say 48. Who is right?
Answer -
That is always an interesting topic... because, pink eye is almost ALWAYS viral, which means that the antibiotic eye drops we prescribe do nothing. If pink eye arises from contacts, it may be bacterial, but the run of the mill pinkeye in kids is always viral. So, the treatment doesn't help. If there is careful handwashing, it is not contagious, but kids are not careful. It probably takes about 3-4 days before someone isn't contagious.
Straight from the ophtho textbook
How can a doctor determine whether pink eye is viral or bacterial or do they just treat it anyway?
Answerwell, that is another silly part of medicine. We typically assume it is viral,when there are no contact lenses involved or trauma involved. But, schools "demand" that the child be on antibiotics prior to returning, so we simply give them. It is a terrible waste of money and medicines. Typically if it doesn't start going away in a couple of days, or there is a tremendous amount of pus, we may culture, or treat blindly with a broad spectrum antibiotic appropriately. I didn't mention gonorrhea of the eye, since it is very rare among school kids. We only culture difficult cases, basically.
